Pediatric Short Gut/Intestinal Failure Clinic

UW Health's pediatric nutrition support program at American Family Children's Hospital in Madison, Wisconsin, offers comprehensive, individualized care for children with complex nutritional needs.

Our team of experts in the Pediatric Short Gut/Instetinal Failure Clinic provides patients with advanced medical and nutritional support and optimizes care by offering the most advanced therapies and the latest in clinical trials.

We take a family-centered approach to your child’s care by including parents in the treatment plan to ensure the course of treatment is a best fit for the patient and their family. Our goal is to provide standardized care and management of patients with short gut syndrome (SGS) and other complex nutritional needs.

Our Team

Patients are seen by each member of our pediatric nutrition support team, which consists of a pediatric surgeon, pediatric gastroenterologist, pharmacy specialist and registered dietitian.

The most common cause of intestinal failure is short gut syndrome (SGS). SGS is a complex of symptoms that result from removal of a large portion of the small intestine. It can also be attributed to functional disease, trauma, pseudo-obstruction, motility disorders or absorption disorders/microvillus disease.

The small intestine is primarily responsible for food digestion and absorption of nutrients. In SGS, the small intestine often ends up widened and less effective at absorbing food. Children with SGS face multiple challenges - they experience poor absorption of nutrients and often times rely on intravenous feedings.

Common Causes of SGS

The main cause of SGS is surgical removal of half or more of the small intestine to treat intestinal diseases, injuries or defects present at birth.

The main treatment for short bowel syndrome is nutritional support. Treatment may involve use of oral rehydration solutions, parenteral nutrition, enteral nutrition and medications.

Oral rehydration solutions consist of sugar and salt liquids

Parenteral nutrition delivers fluids, electrolytes and liquid nutrients into the bloodstream intravenously (through a tube in a vein)

Enteral nutrition delivers liquid food to the stomach or small intestine through a feeding tube.

Pharmacological intervention also is essential to children with SGS. Our pharmacy specialist is available seven days a week to provide appropriate medication. Medicines are used in children with SGS to:

Slow the movement of food through the small intestine

Modify nutrition

Stimulate nutrient absorption

Inhibit bacterial growth

Hormones also can be used to promote growth of the bowel lining (mucosa), which helps it absorb more nutrients.

Surgical Treatment Options for SGS

Surgery could be performed to lengthen or adapt the small intestine to increase the absorptive surface and propel food. Intestinal transplantation is also an option for patients who do not respond to other treatment or experience complications from total parenteral nutrition.
Learn about intestinal (small bowel) transplantation

UW Health surgeons were the first in the state to perform the Serial Transverse Enteroplasty (STEP) procedure on children with SGS.
Read article (pdf)

The procedure lengthens the bowels and creates a more efficient environment for nutrients to be absorbed. In widened, static intestine, bacteria collect and lead to overgrowth and recurrent infection. STEP lengthens the intestine without diminishing the absorptive surface which allows for more motility and better geometry to propel food.

UW Health physical therapist Wendy Stewart also works with patients in the Pediatric Short Gut/Intestinal Failure Clinic.